Objective To evaluate the efficacy and safety of dezocine versus sufentanil for postoperative patient-controlled epidural analgesia (PCEA).Methods PubMed,EMBASE,Cochrane Library,ISI Web of knowledge,Chinese Biomedical Database,Chinese Science-Technology Journal Database,China Journal Full-text Database and Wanfang Database were searched for randomized controlled trials involving the efficacy and safety of dezocine and sufentanil for PCEA from the date of database establishment up to April 2014.Randomized controlled trials met the inclusion criteria were included,and the data were extracted.The quality of the trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.1 software.Results Seven studies involving 760 patients were included in this meta-analysis.The results of meta-analyses showed that there was no significant difference between dezocine group and sufentanil group in VAS scores at 4,8,12,16,24 and 48 h after surgery and in Ramsay sedation scores at 4,12,24 and 48 h after surgery,and the incidence of adverse reactions (postoperative nausea and vomiting,pruritus,urinary retention and somnolence) was significantly lower in dezocine group than in sufentanil group,and there was no significant difference in the incidence of respiratory depression and dizziness between dezocine group and sufentanil group.Conclusion Dezocine provides better efficacy and safety for postoperative PCEA than sufentanil.

Objective : To study the effect of leucine rich repeat kinase 2 ( LRRK2) on pain sensitivity in neuro- pathic pain (NP) rats and explore its possible mechanism． Methods : 48 SD rats were randomly divided into four groups : sham surgery (Sham) ，model，LRRK2 inhibitor(MLi-2) ，and LRRK2 inhibitor + p38 mitogen activated pro- tein kinase (MAPK) agonist (MLi-2 + Anisomycin) ，with 12 rats in each group．The NP rat model was induced by chronic constriction injury ( CCI) of the sciatic nerve．Intrathecal injection of MLi-2 ( 1 mg / kg，10 μl) or Anisomy- cin (20 μmol / L，10 μl) was started from the 8 th day after surgery，once a day for 7 consecutive days．Pain sensi- tivity tests were conducted before surgery (day 0) and on postoperative days 7 and 14，respectively．The changes in mechanical withdrawal threshold (MWT) and paw withdraw thermal latency (PWTL) were analyzed in each group of rats．ELISA was used to detect the levels of interleukin-1 β (IL-1 β) ，IL-6 and tumor necrosis factor-α (TNF-α) in the dorsal horn of the rat spinal cord．Nissl staining was used to observe the pathological changes of neurons in rat spinal cord tissue．Immunofluorescence staining was used to observe the expression levels of ionized calcium-binding adapter molecule-1 (Iba-1) ，a marker of microglia in the spinal cord of rats ．Western blot was used to detect theprotein expression levels of LRRK2，p-p38 mitogen activated protein kinase (MAPK) ，p38 MAPK，and Iba-1 in the dorsal horn of the rat spinal cord. Results : Compared with the sham group，the model group showed a significant decrease in MWT and PWTL in the right hind limb of rats (P＜0. 01) ．The levels of IL-1，IL-6，and TNF in the spi- nal dorsal horn tissue，as well as the expression levels of LRRK2，Iba-1 proteins and p-p38 MAPK / p38 MAPK pro- tein ratio significantly increased (P＜0. 01) ．The proportion of Iba-1 positive cells in the spinal cord tissue signifi- cantly increased (P＜0. 01) ，while Nissl bodies were significantly reduced (P＜0. 01) ．Compared with the model group，the MLi-2 group showed a significant increase in MWT and PWTL in the right hind limb of rats (P＜0. 01) ， a significant increase in Nissl bodies (P＜0. 01) ，a significant decrease in the proportion of Iba-1 positive cells in the spinal cord tissue (P＜0. 01) ，and a significant decrease in the levels of IL-1，IL-6，and TNF and the expression levels of LRRK2，Iba-1 proteins and p-p38 MAPK / p38 MAPK protein ratio (P＜0. 01) ．However，Anisomychin in- tervention could activate the p38 MAPK signaling pathway and partially reverse the beneficial effects of MLi-2 on pain sensitivity and neuroinflammation in rats with neuropathic pain． Conclusion Inhibiting the expression of LRRK2 can alleviate pain sensitivity in NP rats induced by microglia activation mediated neuroinflammation，and its mechanism of action may be related to regulating the p38 MAPK signaling pathway.